medwireNews: Molecular analysis of a single tumour sample may be insufficient to guide treatment choices in men with localised prostate cancer.
Using next-generation sequencing techniques, a research team found considerable genetic heterogeneity among three noncontiguous samples obtained from the index prostate cancer lesion and also between biopsy cores from the index and other smaller lesions.
The samples varied at the level of individual somatic mutations, copy number alterations and gene fusions, report Hannelore Heemers, from the Cleveland Clinic in Ohio, USA, and colleagues.
There was also heterogeneity with regard to molecular classification systems and the expression of genes that underlie genomic risk stratification and prognostication assays, such as Prolaris and Oncotype Dx.
“Clinicians need to be careful about using the information from a gene-based test, because the analysis may not have been performed on the most aggressive portion of a man’s prostate cancer”, study author James Mohler (Roswell Park Cancer Institute, Buffalo, New York, USA) told the press.
The study, published in European Urology, included four prostate cancer patients with localised intermediate- or high-risk disease who underwent radical prostatectomy without neoadjuvant chemotherapy.
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